Members are reminded to consider the categories of interest in the Code of Conduct for Members to determine whether they have an interest in any agenda item and any action they should take. For further details, please see the attached note from the Monitoring Officer.

Members are reminded to declare the nature of the interest and the agenda item it relates to. Please note that ultimately it’s the Members’ responsibility to declare any interests and to update their register of interest form as required by the Code.

If in doubt as to the nature of your interest, you are advised to seek advice prior to the meeting by contacting the Monitoring Officer or Democratic Services

No declarations were received at the meeting.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 6^th July, 2022.

RESOLVED

That the unrestricted minutes of the meeting of the Sub-Committee held on Thursday, 16th September 2022 were agreed as a correct record of the proceedings.

The Sub-Committee received a presentation that provided an introduction to the Integrated Care System in North East London and how Tower Hamlets Together Partnership will be involved in (i) the key challenges and pressures; and (ii) priorities for the year.  The main point may be summarised as follows:

The Sub-Committee:

• Expressed concern that the cost-of-living crisis will raise stress levels due to the looming anxiety of increased energy bills to the day-to-day struggle of trying to make ends meet.

• Commented that over time, this persistent stress would potentially trigger or worsen mental illnesses such as anxiety disorders, depression, and addiction.
• Were concerned that Barts Health are also facing rising fuel and energy bills and noted that the Trust leaders are working hard to find savings and efficiency measures to ensure that the Trusts group of hospitals can continue to provide clinical services to people in east London and beyond.

• Commented that the economic pressures will make long-standing health inequalities even worse in east London as they take their toll on people's health and wellbeing. Therefore, the Trust and its partners needs to address the wider causes of poor health and help to close the gap in healthy life expectancy between people in the deprived and affluent areas of east London.
• Noted that the cost and severity of capital budgets are now set to rise in cash terms by 2024/25. Part of the planned increase to capital investment being tied to programmes to build or upgrade hospitals, build surgical hubs and community diagnostic centres, and increase spending on digital technology and research and development.

• Acknowledged that Barts Health like any area of public sector is not immune from consideration of reductions in its budgets.
• Noted that Barts Health is making sure that its workforce is supported through the cost-of-living crisis and that the wages that they get are at a level that can support them support them which therefore is another consideration of the Integrated Care System (ICS) as it brings together the NHS organisations, councils, and wider partners in a defined geographical area to deliver more joined up approaches to improving health and care outcomes.
• Agreed that the Trust and its partners recognises that they must be able to respond to the needs of their local communities while maintaining crucial services and retaining staff across acute, ambulance, community, and mental health services.
• Noted that the responsibility for commissioning local dental services in east London rests not through the local integrated care board (ICB) but with the local area teams who hold the budget and have powers to contract for the provision of dental services according to the needs of the Borough’s residents.
• Noted, that there are plans and proposals being developed to transfer the commissioning local dental, ophthalmology, and pharmacy services to the ICB from April, 2023.
• Noted that whilst there are rising numbers of people in east London are struggling to access NHS dentistry as the pandemic had created backlogs and worsened access to these services the public  ...  view the full minutes text for item 3.1

The Sub-Committee received a presentation on workforce shortages across the Adult Social Care (ASC) sector which covered: (i) ASC recruitment challenges and pressures; (ii) growth and progression options for ASC workforce; and (iii) resource implications and impact on performance.   The main points of the discussion on this presentation summarised as follows:

The Sub-Committee:

·         Indicated that Zero hours contracts should have no place in the NHS or elsewhere as at the end of the day, a pressured, demoralised and casualised workforce will end up impacting on patient care.  However, it was acknowledged that there are benefits to zero-hour contracts as they can be a flexible option for both employers and workers. As (i) the employer does not have to give an employee any minimum working hours; and (ii) the employee does not have to take any work offered (e.g., some people choose not to have any guaranteed hours to fit care around the childcare around the school hours and want that flexibility). However, the Health and Social Care Sector should comply with the ethical Care Charter principle and offer people the right to have a fixed contracts where they were they wish.

·         Noted that there is no evidence that employees are leaving the Health and Social Care Sector because they are not getting offered contracts. Also, the Trust and its partners are having more discussion with those providers to look at what are the reasons for employees deciding not to accept the contracts that they have offered.

• Agreed that a workforce strategy is needed because:

                               I.        the growing population within Tower Hamlets and the increase in the levels of demand.

                             II.         The workforce does not fully reflect the local population.

                            III.        the current age of workforce is 45 or older

                           IV.        many people coming into social work are changing profession.

• Noted that the following recruitment strategies are currently in place (A) workforce dashboard recently developed to allow monitoring against all protected characteristics; (B) a three year career development plan for all newly qualified social workers recruited; (C) offering on average 15 placements to student social workers each year through partner Universities to provide a ready-made recruitment pool; (D) varying recruitment methods to include virtual recruitment events; and (E) the number of requirements which need to be met at application stage reduced so as to encourage applications.
• Noted that structural inequalities would be addressed by (1) talking to local community about barriers; (2) reviewing the current recruitment processes; (3) reviewing where and how posts are advertised; (4) providing simple guidance for people in local community on submitting applications, writing CVs and consider workshops around interview skills; (5) offer greater flexibility around work patterns – in line with needs of service; (6) providing coaching to support existing BAME staff to be successful in applying for higher level roles; (7) offering apprenticeships in social work and occupational therapy.
• Noted that for the Boroughs Care Homes and Extra Care (housing with care) face the following challenges (i) bank staff members are prevalent in the  ...  view the full minutes text for item 3.2

The Sub-Committee received a copy of the Scrutiny Work Programme 2022/23 which includes the Health and Adults Scrutiny Sub-Committee (HASSC) Work Programme 2022/23 as set out in appendix 2 of the report.

The Sub-Committee Resolved to:

Agree the Work Programme 2022/23 as set out in appendix 2 of the report.

With no other business to discuss, the Chair called the meeting to a close and thanked everybody for their attendance and participation tonight.